Provider Demographics
NPI:1376903567
Name:KRIEGER, DANIELLE ROSE (DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ROSE
Last Name:KRIEGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15839 JEWEL AVE
Mailing Address - Street 2:APT TB
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3059
Mailing Address - Country:US
Mailing Address - Phone:201-390-4893
Mailing Address - Fax:
Practice Address - Street 1:3136 88TH ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-1415
Practice Address - Country:US
Practice Address - Phone:718-205-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039776-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist